Loading...
1987, 01-29 Permit App: 87000215 Water SoftenerCO w cc 1- x X LL LL O w z 2 .JMBING PERMIT APPLICATION WORKSHEET .r1D COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND (V-4. IProject N /'1/S .(ame Last First MI Dills Teresa Project Address (Street Name & Number) City State Subdivision/Plat Name U-)Es—rALLEY 2-1.-)0.Assessors Parcel N C7541/— 0322 Lot 8 Block / 'L Plat N /roe° 'Y Applicant Same Address N. 2017 Laura Rd. City Spokane I State WA Zip 99206 Phone 928-9693 Business Phone Contractor Address City I State Zip Phone Contact Licenseft Business Phone Describe Work Bar Sink(s)' Drinking Fountain(s): Floor Drain(s): Washing Machine(s): Dsh Wshr(e): Garb Diop(e): Kit Sink(s): Lndry Tray(s). Sew Eject(s): Urinal GI: Wtr Closet(s): Lav(s): Shower(s): Tub(s): Bidet(s): Other: TYPO; Water Softener! Waste/Grease Interceptor(s): Sewer Y N Septic/ Health No.: Electric Water Heater(s): Drains -Roof: REPAIR OR ALTERATION: Drainage, Vent, Water Piping /Treatment. Y N Lawn Sprinkler System(s), Including backf low device on any one meter: Vacuum breakers or backflow devices in excess o1 line 16:1-5: (Or) 5+: I certify that the above information as submitted by me is true and correct and further, agree that all pro- visions of laws and ordinances governing this type of work, including inspection requirements, will be com- plied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state of local laws regulating construction or the performance of construction. SIGNATURE OF APPLICATION Soft Water Service Co. OWNER OR AGENT DATE